Low-Cost Vaccine Clinic Registration 5/2/26

Diane’s team has been providing low-cost vaccine clinics for decades.

Vaccine Clinic Registration

Date of Clinic: 5-2-26

Location: Ultimate Doggie Destination

Philadelphia Premium Outlets, 18 Lightcap Rd

Pottstown, PA 19464

For easy access park behind Nike

We cannot accept feral cats at the vaccine clinic.

All aggressive dogs must be muzzled before arriving at the vaccine clinic.

Pet Owner Name*

First NameLast Name

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Area Code and Phone Number *

Appointment Time Slot*

PET(S) Information

IMPORTANT - PLEASE READ BEFORE CONTINUING

This section must be filled out completely and correctly.

Failure to follow these instuctions will cause delays, invalid paperwork, and longer wait times for everyone.

Pet(s) Name: Spell it how you want it on your documents we will not correct spelling

Dog or Cat: DO NOT LEAVE BLANK

Age: Years or Months (Y=Years or M=Months)

Spayed/Neutered: Yes or No

If your dog/cat is spayed or neutered, enter YES.
If not, enter NO.

Breed (required):

Dogs: Do NOT write “mixed.” Instead, list the predominant breed, followed by “mix” (e.g., Lab mix).

Cats: Do not leave blank. Typical cat breed entries are:

DSH (Domestic Short Hair)
DLH (Domestic Long Hair)
or the specific purebred breed

Rabies: 1 or 3

If your dog/cat is getting a Rabies Vaccine, enter 1 for 1-year or 3 for 3-year
If not, enter NO.

If you are unsure about how to fill out this form or have questions, PLEASE email vaccine.clinic@ddpets.com. I'm happy to help ensure your pet is gets the right care.

Is your pet(s) getting a Rabies Vaccine at this clinic?*

YESNO

3-Year Rabies: Upload proof of previous rabies vaccine.

upload file

PET(S) Information: List all pets receiving vaccines. Enter age in YEARS or MONTHS.*

Rows	Pet Name	Dog or Cat	Age Years or Months	Predominant Breed	Color	Gender M or F	Spayed/Neutered YES or NO	Weight: Under 20lbs. 20-50 Over 50	Rabies: 1 or 3
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Dog: Vaccine Recommendation

Cat: Vaccine Recommendation

We cannot vaccinate pets that have had a previous reaction to a vaccination. Owner is financially responsible for any vaccination reactions. Who to call in the case of an Emergency: Pottstown Urgent Vet. #484-763-4500 Metropolitan Emergency Service (610) 666-0914 or Veterinary Referral Center (610) 647-2950*

I understand

Upload an Active Prescription/Proof of a Heartworm test within the last 12 months for purchase of RX items.

upload file

SERVICES AND QUANTIY

Notes:

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(office use only)

Test Results:

Heartworm:                            Lyme:&#13;&#10;&#13;&#10;Erlichia:                                  A.Platys:&#13;&#10;&#13;&#10;FeLV:                                      FIV:&#13;&#10;&#13;&#10;&#13;&#10;

(office use only)

Services*

WELLNESS PACKAGES

Puppy Starter Package 6-8 Weeks (Save $5)

Includes:

• DAPPv (5 in 1 Vaccine)

• Pyrantel Pamoate Dewormer (roundworms & hookworms)

• Dog Nail Trim

$35.00 Quantity

Puppy Booster Package 12-16 Weeks (Save $5)

Includes:

• Nobivac Rabies (1 year)

• DAPPV+L4 (9 in 1 Vaccine)

• Single Dose Iverhart Plus (Generic for Heartgard Plus® – protects against heartworm, roundworms & hookworms)

• Dog Nail Trim

$70.00 Quantity

Adult Dog Package (Save $7)

Includes:

• Nobivac Rabies (1 or 3 year)

• DAPPV+L4 (9 in 1 Vaccine)

• Heartworm/Lyme/Erlichia/A.Platys (4DX)

• Heart & Lung Check

• Single Dose Iverhart Plus (Generic for Heartgard Plus® – protects against heartworm, roundworms & hookworms))

• BRAVECTO Topical (12-Week Flea & Tick Protection) Applied at the Vaccine Clinic

$120.00 Quantity

Small Breed Dog Package (Save $5)

Includes:

• IMRAB Rabies (1 or 3 year)

• Edge DAPPV+L4 (9 in 1 Vaccine)

• Heartworm/Lyme/Erlichia/A.Platys (4DX) Test

• Heart & Lung Check

• Single Dose Iverhart Plus (Generic for Heartgard Plus® – protects against heartworm, roundworms & hookworms)

$95.00 Quantity

Social Dog Package - Dog Park / Daycare & Boarding (Save $7)

Includes:

• Nobivac Rabies (3 year)

• DAPPV+L4 (9 in 1 Vaccine)

• Canine Intra-Trac® Oral Bb (Kennel Cough)

• Nobivac® NXT Canine Flu H3N2

• Heartworm/Lyme/Erlichia/A.Platys (4DX)

• Heart & Lung Check

• Single Dose Iverhart Plus (Generic for Heartgard Plus®) (Heartworm, Rounds & Hooks)

• BRAVECTO Topical (12 -Week Flea & Tick Protection) Applied at the Vaccine Clinic

$195.00 Quantity

Kitten Starter Package 8-10 Weeks (Save $7)

Includes:

• Nobivac® Feline 1-HCPCh

• FELV/FIV Combo Test

• Selarid (Generic for Revolution®) (heartworms, fleas, ear mites, roundworms, and hookworms)

• Cat Nail Trim

$75.00 Quantity

Kitten Booster Package 12-14 Weeks (Save $5)

Includes:

• Nobivac® Feline 1-HCPCh

• Nobivac Rabies (1 year)

• Selarid (Generic for Revolution®) (heartworms, fleas, ear mites, roundworms, and hookworms)

• Cat Nail Trim

$57.00 Quantity

Adult Cat Package (Save $5)

Includes:

• Nobivac® Feline 1-HCPCh

• Nobivac Rabies (1 or 3 year)

• Selarid (Generic for Revolution®) (heartworms, fleas, ear mites, roundworms, and hookworms)

$57.00 Quantity

DOG VACCINES

Nobivac® Canine DAPPv (5 in 1 Vaccine) Sale -Save $9 (Reg. $19)

DAPPv (5 in 1 Vaccine):

• Protects against Distemper, Hepatitis, Parvo, and Parainfluenza

• Core vaccine recommended for all dogs

• Puppies require a series of vaccines given every 2–4 weeks until at least 12 weeks of age, followed by yearly boosters.

• Recommended for healthy dogs 6 weeks of age and older.

• Annual revaccination with 1 dose is recommended

$10.00 Quantity

Nobivac® Canine DAPPv+Cv (6 in 1 Vaccine)

Nobivac® Canine DAPPv + Coronavirus (6-in-1):

• Protects against distemper, adenovirus types 1 & 2, parainfluenza, parvovirus, and coronavirus.

• Core vaccine recommended for all dogs

• Recommended for healthy dogs 6 weeks of age and older.

• Puppies require boosters every 2–4 weeks until at least 12 weeks of age, then yearly boosters.

$20.00 Quantity

Nobivac® Canine DAPPv+L4 (9 in 1 Vaccine)

Core vaccine recommended for puppies and adult dogs to protect against serious viral diseases.

• Protects against distemper, adenovirus (Type 1 & 2), parainfluenza, parvovirus, and 4-way leptospirosis

• Recommended for healthy dogs 8 weeks of age and older

• Puppies require boosters every 2–4 weeks until at least 12 weeks of age, then yearly boosters.

• A minimum of two doses is required for primary immunization. Annual revaccination with one dose recommended

$25.00 Quantity

Nobivac® Edge DAPPV+L4 (9 in 1 Vaccine for Small Dogs)

Core vaccine recommended for puppies and adult dogs to protect against serious viral diseases. Half-volume formula designed for small breed dogs.

• Protects against distemper, adenovirus (Type 1 & 2), parainfluenza, parvovirus, 4-way leptospirosis

• Recommended for healthy dogs 6 weeks of age and older.

• Puppies require boosters every 2–4 weeks until at least 12 weeks of age, then yearly boosters.

• A minimum of two doses is required for primary immunization. Annual revaccination with one dose recommended

$26.00 Quantity

Nobivac® Canine Lepto4 Sale - Save $5 (Reg. $21)

• Protects against 4 strains of leptospirosis, a serious bacterial disease that dogs usually pick up from contaminated water or soil.

• Leptospirosis affects the liver and kidneys and can often be fatal.

• Core vaccine recommended for all dogs

• Recommended for all dogs 8 weeks of age and older. Booster 2 to 4 weeks later. Annual revaccination with one dose is recommended

$16.00 Quantity

Nobivac® Lyme Vaccine For Dogs Sale - Save $4 (Reg. $42)

Common in tick-endemic areas.

• Protects against Lyme disease, a tick-borne illness that can cause joint pain, lameness, fever, and kidney damage.

• Recommended for dogs 8 weeks of age and older. • Two doses required 2–4 weeks apart. Annual revaccination with one dose is recommended

• Helps reduce risk of infection in tick-prone areas

$38.00 Quantity

Nobivac® Canine Intra-Trac® Oral Bb (Kennel Cough Oral)

Recommended for dogs that go to groomers, daycare, boarding, or dog parks.

• Helps prevent kennel cough (Bordetella) for dogs 7 weeks of age and older.

• Annual booster recommended.

$21.00 Quantity

Nobivac® NXT Canine Flu H3N2

Recommended for dogs that go to groomers, daycare, boarding, or dog parks.

• Low-volume dog influenza vaccine protects against canine influenza (dog flu) H3N2 strain.

• Recommended for dogs 8 weeks of age and older. Two doses required 3–4 weeks apart.

• Preservative, adjuvant and thimerosal free

• Triggers a robust response without the use of an adjuvant or live organisms

$29.00 Quantity

Nobivac® Rabies Vaccine Dog

Required by law in PA for pets 3 months of age and older.

• Protects against rabies, a fatal viral disease

• Provides 3-year protection when prior rabies vaccination can be verified

• Pets without proof of prior rabies vaccination will receive a 1-year rabies vaccine

• Official rabies certificate provided

$22.00 Quantity

Rabies Vaccine (IMRAB 3 Year – Thimerosal Free) DOG

IMRAB® 3 Year – Thimerosal Free vaccines are strongly recommended for dogs and cats with autoimmune conditions, allergies, or smaller breeds.

• Protects against rabies, a fatal viral disease

• Required by law in PA for pets 3 months of age and older

• Provides 3-year protection when prior rabies vaccination can be verified

• Pets without proof of prior rabies vaccination will receive a 1-year rabies vaccine

• Official rabies certificate provided

$28.00 Quantity

DOG TESTS

Annual Heartworm & Tick Disease Test (4DX)

Most recommended test for our area.

Heartworm/Lyme/Erlichia/A.Platys (4DX)

• For dogs 6 months of age and older. Annual testing is recommended even for dogs on prevention.

• Simple blood test with fast results tests for heartworm and three common tick-borne diseases including Lyme, Ehrlichia, and Anaplasma.

$40.00 Quantity

Heartworm Only Test – Basic Screening

• Screens for heartworm disease, which is spread by mosquitoes.

• Required before starting heartworm prevention if status is unknown

• Simple blood test

• Recommended once yearly for dogs 6 months of age and older.

$28.00 Quantity

DOG ALL-IN-ONE PREVENTION

Simparica Trio 5.6–11 lbs Dogs – Best Value 6-Month Supply (Save $9)

• All-in-one monthly protection

• Protects against fleas, ticks, heartworm, roundworms, and hookworms all in one convenient once-monthly chewable tablet

• FDA-approved to help prevent infections that may cause Lyme disease by killing deer ticks.

Rx: Requires an active prescription or proof of a negative heartworm test within the past 12 months.

Dispensed at Diane's Pet Rescue Vaccine Clinics

$165.00 Quantity

Simparica Trio 5.6-11 lbs. Dogs, 1 Month Supply

$29.00 Quantity

Simparica Trio 11.1-22 lbs. Dogs – Best Value 6-Month Supply (Save $10)

• All-in-one monthly protection

• Protects against fleas, ticks, heartworm, roundworms, and hookworms all in one convenient once-monthly chewable tablet

• FDA-approved to help prevent infections that may cause Lyme disease by killing deer ticks.

Rx: Dispensed at Diane's Pet Rescue Vaccine Clinics

$176.00 Quantity

Simparica Trio 11.1-22 lbs. Dogs, 1 Month Supply

$31.00 Quantity

Simparica Trio 22.1–44 lbs. Dogs – Best Value 6-Month Supply (Save $6)

• All-in-one monthly protection

• Protects against fleas, ticks, heartworm, roundworms, and hookworms all in one convenient once-monthly chewable tablet

• FDA-approved to help prevent infections that may cause Lyme disease by killing deer ticks.

Rx: Requires an active prescription or proof of a negative heartworm test within the past 12 months.

Dispensed at Diane's Pet Rescue Vaccine Clinics

$186.00 Quantity

Simparica Trio 22.1-44 lbs. Dogs, 1 Month Supply

$32.00 Quantity

Simparica Trio 44.1-88 lbs. Dogs – Best Value 6-Month Supply (Save $9)

• All-in-one monthly protection

• Protects against fleas, ticks, heartworm, roundworms, and hookworms all in one convenient once-monthly chewable tablet

• FDA-approved to help prevent infections that may cause Lyme disease by killing deer ticks.

Rx: Requires an active prescription or proof of a negative heartworm test within the past 12 months.

Dispensed at Diane's Pet Rescue Vaccine Clinics

$195.00 Quantity

Simparica Trio 44.1-88 lbs. Dogs, 1 Month Supply

$34.00 Quantity

DOG HEARTWORM & PARASITE PREVENTION

Sentinel Spectrum Chew for Dogs, 50.1-100 lbs, (Blue Box), 6 Chews (6-mos. supply)

SENTINEL SPECTRUM is a monthly oral preventive prescription that protects your pet against heartworms, adult roundworms, adult hookworms, whipworms, and prevents the development of flea eggs.

Rx: Requires an active prescription or proof of a negative heartworm test within the past 12 months.

Dispensed at Diane's Pet Rescue Vaccine Clinics

$71.00 Quantity

Iverhart Plus (Generic for Heartgard Plus®) Flavored Chewable for Dogs up to 25 lbs. BLUE (6 Month Supply)

• Generic equivalent of Heartgard Plus®

• Monthly flavored chewable tablet

• Prevents heartworm disease

• Treats and controls roundworms and hookworms

• Safe for dogs and puppies 6 weeks and older

• Requires a negative heartworm test within the past 12 months

Rx: Requires an active prescription or proof of a negative heartworm test within the past 12 months.

Dispensed at Diane's Pet Rescue Vaccine Clinics

$27.00 Quantity

Iverhart Plus (Generic for Heartgard Plus®) Flavored Chewable for Dogs up to 25 lbs. BLUE (single dose)

$6.00 Quantity

Iverhart Plus (Generic for Heartgard Plus®) Flavored Chewable for Dogs 26 to 50 lbs. GREEN (6 month supply)

• Generic equivalent of Heartgard Plus®

• Monthly flavored chewable tablet

• Prevents heartworm disease

• Treats and controls roundworms and hookworms

• Safe for dogs and puppies 6 weeks and older

• Requires a negative heartworm test within the past 12 months

Rx: Requires an active prescription or proof of a negative heartworm test within the past 12 months.

Dispensed at Diane's Pet Rescue Vaccine Clinics

$37.00 Quantity

Iverhart Plus (Generic for Heartgard Plus®) Flavored Chewable for Dogs 26 to 50 lbs. GREEN (single dose)

Generic equivalent of Heartgard Plus®

RX: Requires an active prescription or proof of a negative heartworm test within the past 12 months

$7.00 Quantity

Iverhart Plus (Generic for Heartgard Plus®) Flavored Chewable for Dogs 50 to 100 lbs. BROWN (6 Month Supply)

• Generic equivalent of Heartgard Plus®

• Monthly flavored chewable tablet

• Prevents heartworm disease

• Treats and controls roundworms and hookworms

• Safe for dogs and puppies 6 weeks and older

• Requires a negative heartworm test within the past 12 months

Rx: Requires an active prescription or proof of a negative heartworm test within the past 12 months.

Dispensed at Diane's Pet Rescue Vaccine Clinics

$48.50 Quantity

Iverhart Plus (Generic for Heartgard Plus®) Flavored Chewable for Dogs 50 to 100 lbs. BROWN (single dose)

Generic equivalent of Heartgard Plus®

RX: Requires an active prescription or proof of a negative heartworm test within the past 12 months

$9.00 Quantity

Selarid (Generic for Revolution®) Puppies & Kittens, 0-5 lbs. (single dose)

Generic equivalent of Revolution® (selamectin)

• Monthly topical treatment for puppies and kittens

• Kills adult fleas and prevents flea eggs from hatching

• Helps prevent heartworm disease

• Treats ear mites, roundworms, and hookworms

• Provides the same broad protection as Revolution® at a lower cost

Rx: Dispensed at Diane's Pet Rescue Vaccine Clinics

$11.00 Quantity

DOG 3-MONTH FLEA & TICK PREVENTION

BRAVECTO Topical for Dogs 4.4-9.9 lbs. (Yellow Box)

BRAVECTO applied at the vaccine clinic provides long-lasting flea and tick protection:

• 1 dose protects for 12 weeks (3 months)

• Nearly 3× longer protection than monthly flea & tick products

• No monthly dosing to remember

• Applied by clinic staff during your visit

Rx: Dispensed at Diane's Pet Rescue Vaccine Clinics

$29.00 Quantity

BRAVECTO Topical for Dogs 9.9-22 lbs. (Orange Box)

BRAVECTO applied at the vaccine clinic provides long-lasting flea and tick protection:

• 1 dose protects for 12 weeks (3 months)

• Nearly 3× longer protection than monthly flea & tick products

• No monthly dosing to remember

• Applied by clinic staff during your visit

Rx: Dispensed at Diane's Pet Rescue Vaccine Clinics

$30.00 Quantity

BRAVECTO Topical for Dogs 22-44 lbs. (Green Box)

BRAVECTO applied at the vaccine clinic provides long-lasting flea and tick protection:

• 1 dose protects for 12 weeks (3 months)

• Nearly 3× longer protection than monthly flea & tick products

• No monthly dosing to remember

• Applied by clinic staff during your visit

Rx: Dispensed at Diane's Pet Rescue Vaccine Clinics

$31.00 Quantity

BRAVECTO Topical for Dogs 44-88 lbs. (Blue Box)

BRAVECTO applied at the vaccine clinic provides long-lasting flea and tick protection:

• 1 dose protects for 12 weeks (3 months)

• Nearly 3× longer protection than monthly flea & tick products

• No monthly dosing to remember

• Applied by clinic staff during your visit

Rx: Dispensed at Diane's Pet Rescue Vaccine Clinics

$32.00 Quantity

BRAVECTO Topical for Dogs 88-123 lbs. (Pink Box)

BRAVECTO applied at the vaccine clinic provides long-lasting flea and tick protection:

• 1 dose protects for 12 weeks (3 months)

• Nearly 3× longer protection than monthly flea & tick products

• No monthly dosing to remember

• Applied by clinic staff during your visit

Rx: Dispensed at Diane's Pet Rescue Vaccine Clinics

$34.00 Quantity

MISC. DOG & CAT

Dog Nail Trim

• Helps keep your dog’s nails at a healthy length

• Prevents nails from curling, splitting, or growing into the paw pad

• Reduces the risk of pain, infection, and joint stress

• Helps prevent nails from catching on carpet, blankets, or collars

• Regular trimming supports healthy feet and comfortable walking

$20.00 Quantity

Cat Nail Trim

• Helps keep your cat’s nails at a healthy length

• Prevents nails from curling and growing into paw pads

• Reduces the risk of pain, infection, and injury

• Helps prevent changes in your cat’s gait and joint stress

• Supports healthy feet and comfortable movement

$10.00 Quantity

HomeAgain Microchip – Permanent Pet ID Sale - Save $12 (Reg. $37)

( Regular Price $37)

• Quick procedure similar to a routine vaccination

• Tiny microchip about the size of a grain of rice

• Permanent ID to help reunite lost pets with their families

• Lifetime registration included

• 1-year HomeAgain membership included

$25.00 Quantity

Dewormer (Rounds & Hooks)

Pyrantel Pamoate – Dewormer

• Treats and controls roundworms and hookworms

• Common intestinal parasites in puppies and kittens

• Puppies and kittens often require treatment every 2–3 weeks until 12 weeks of age

$10.00 Quantity

CAT VACCINES

Nobivac® Feline 1-HCPCh (Cat Distemper Combo)

• Protects against Feline Rhinotracheitis, Calicivirus, and Panleukopenia

• Also protects against Chlamydia psittaci

• Thimerosal-free vaccine

• Recommended for healthy kittens 9 weeks of age and older

• Kittens require 2 doses given 3–4 weeks apart

• Booster every 3–4 weeks until 16–20 weeks of age, then annual revaccination

$19.00 Quantity

Nobivac® Feline 2-FeLV (Feline Leukemia Vaccine)

• Protects cats against Feline Leukemia Virus (FeLV)

• Helps prevent persistent viremia

• Killed virus vaccine

• Thimerosal-free

• Recommended for kittens 9 weeks of age and older

• Second dose given 3–4 weeks later

• Booster every 2 years

$38.00 Quantity

Nobivac® Rabies Vaccine Cat

Nobivac® Rabies Vaccine – Cat (1 yr or 3 yr)

Provides rabies protection for dogs. If proof of a previous rabies vaccine is provided, a 3-year certificate may be issued. Without proof, a 1-year certificate will be issued

$22.00 Quantity

Rabies Vaccine (IMRAB 3 Year – Thimerosal Free) CAT

IMRAB® 3 Year – Thimerosal Free vaccines are strongly recommended for dogs and cats with autoimmune conditions, allergies, or smaller breeds.

• Protects against rabies, a fatal viral disease

• Required by law in PA for pets 3 months of age and older

• Provides 3-year protection when prior rabies vaccination can be verified

• Pets without proof of prior rabies vaccination will receive a 1-year rabies vaccine

• Official rabies certificate provided

$28.00 Quantity

CAT TEST

FELV/FIV Combo Test

• Screens for Feline Leukemia Virus (FeLV) and Feline Immunodeficiency Virus (FIV)

• Kittens can be tested for FeLV starting at 8 weeks of age

• Positive or negative FIV results in kittens should be confirmed at 6 months of age

$42.00 Quantity

CAT FLEA & TICK

Bravecto Topical Solution for Cats, >6.2-13.8 lbs, (Blue Box) 12 weeks

• Topical flea and tick treatment for cats

• Up to 12 weeks (3 months) of flea protection

• Controls black-legged ticks for 12 weeks

• Controls American dog ticks for up to 8 weeks

• One easy topical application

• For cats and kittens 6 months of age or older

• For cats weighing 2.6 lbs. or more

Rx: Dispensed at Diane's Pet Rescue Vaccine Clinics

$59.00 Quantity

CAT HEARTWORM & PARASITE PREVENTION

Selarid (Generic for Revolution®) Puppies & Kittens, 0-5 lbs. (single dose)

Generic equivalent of Revolution® (selamectin)

• Monthly topical treatment for puppies and kittens

• Kills adult fleas and prevents flea eggs from hatching

• Helps prevent heartworm disease

• Treats ear mites, roundworms, and hookworms

• Provides the same broad protection as Revolution® at a lower cost

Rx: Dispensed at Diane's Pet Rescue Vaccine Clinics

$11.00 Quantity

Selarid (Generic for Revolution®) Cats, 5.1-15 lbs. (single dose)

• Same active ingredient as Revolution® (selamectin)

• Monthly topical treatment for cats

• Kills adult fleas and prevents flea eggs from hatching

• Helps prevent heartworm disease

• Treats ear mites, roundworms, and hookworms

• Broad-spectrum parasite protection at a more affordable price

Rx: Dispensed at Diane's Pet Rescue Vaccine Clinics

$11.50 Quantity

Selarid (Generic for Revolution®) Cats, 15.1-22 lbs. (single dose)

• Same active ingredient as Revolution® (selamectin)

• Monthly topical treatment for cats

• Kills adult fleas and prevents flea eggs from hatching

• Helps prevent heartworm disease

• Treats ear mites, roundworms, and hookworms

• Broad-spectrum parasite protection at a more affordable price.

Rx: Dispensed at Diane's Pet Rescue Vaccine Clinics

$12.00 Quantity

Total

$0.00

Authorization to treat pets - Owner's signature*

(signature required at vaccine clinic)

Please keep this paper proof of vaccines and testing. There is a $5.00 reprint fee.*

I understand

**VACCINES NOT VALID WITHOUT VETERINARIAN SIGNATURE**

Dr. Amy Pavlock, VMD

PA Veterinary License #BV010749